TY - JOUR
T1 - The evolving role of interventional pulmonary in the interdisciplinary approach to the staging and management of lung cancer. Part III
T2 - Diagnosis and management of malignant pleural effusions
AU - Yoneda, Ken Y
AU - Mathur, Praveen N.
AU - Gasparini, Stefano
PY - 2007/11
Y1 - 2007/11
N2 - The diagnosis and management of a malignant pleural effusion can be one of the most vexing problems faced by physicians and their patients. Lung cancer is the most common primary tumor of origin with a prognosis that is limited, but variable and correlated with performance status (PS). Therefore, with a poor PS and known advanced lung cancer, establishing whether or not an effusion is malignant might not be necessary. Conversely, identifiable subsets of patients will have a much better survival, and establishing a definitive diagnosis could be of critical importance. In the great majority of cases, a diagnosis can be determined by serial thoracenteses with or without closed pleural biopsy. However, thoracoscopy is increasingly being utilized and can expedite the workup by obviating the need for repeated thoracenteses and/or closed pleural biopsy, while in the same setting providing definitive palliative treatment. Although studies comparing diagnostic and treatment strategies are limited, we will present the available data with the intention of providing the practicing oncologist with a practical strategy for the diagnosis and management of malignant pleural effusions due to lung cancer. The interventional pulmonologist can play an important role from diagnosis to palliation, greatly facilitating the care of patients with malignant pleural effusions.
AB - The diagnosis and management of a malignant pleural effusion can be one of the most vexing problems faced by physicians and their patients. Lung cancer is the most common primary tumor of origin with a prognosis that is limited, but variable and correlated with performance status (PS). Therefore, with a poor PS and known advanced lung cancer, establishing whether or not an effusion is malignant might not be necessary. Conversely, identifiable subsets of patients will have a much better survival, and establishing a definitive diagnosis could be of critical importance. In the great majority of cases, a diagnosis can be determined by serial thoracenteses with or without closed pleural biopsy. However, thoracoscopy is increasingly being utilized and can expedite the workup by obviating the need for repeated thoracenteses and/or closed pleural biopsy, while in the same setting providing definitive palliative treatment. Although studies comparing diagnostic and treatment strategies are limited, we will present the available data with the intention of providing the practicing oncologist with a practical strategy for the diagnosis and management of malignant pleural effusions due to lung cancer. The interventional pulmonologist can play an important role from diagnosis to palliation, greatly facilitating the care of patients with malignant pleural effusions.
KW - Performance status
KW - Pleural biopsy
KW - Pleural effusion
KW - Thoracentesis
KW - Thoracoscopy
KW - Ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=37349024112&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=37349024112&partnerID=8YFLogxK
U2 - 10.3816/CLC.2007.n.040
DO - 10.3816/CLC.2007.n.040
M3 - Article
C2 - 18186958
AN - SCOPUS:37349024112
VL - 8
SP - 535
EP - 547
JO - Clinical Lung Cancer
JF - Clinical Lung Cancer
SN - 1525-7304
IS - 9
ER -